Small arteries called capillaries supply blood to the fingers and toes. In response to temperature or emotion, these blood vessels normally change slightly in size, becoming wider in response to heat and narrower in response to cold.
In Raynaud’s syndrome, the blood vessels narrow too much in the fingers or toes. The lack of blood supply will result in the fingers turning very white. This may be just in the fingertips or ends of the toes. Sometimes entire fingers or toes will turn white. This may be only a few minutes or last much longer. If the blood supply is stopped for two long, severe tissue damage may occur. Fortunately this is uncommon in most Raynaud’s disease. Occasionally the nose or ears will also be involved. The white discoloration may be followed by a bluish color. The area will turn very red when blood supply returns. Raynaud’s syndrome without any obvious cause is called primary Raynaud’s disease. If it is caused by another condition or disease it is called secondary Raynaud’s disease.
In general, Raynaud’s disease occurs in one to several fingers in both hands, or the toes in the feet causing them to sting or feel numb. When the blood returns and there often is a throbbing, swollen or burning sensation. Prolonged Raynaud’s attacks may result in ulcers in fingertips or toes, and rarely the tissue will die from lack of oxygen, similar to gangrene. In rare cases surgery may be needed to remove the dead tissue and to prevent infection.
Most people who have Raynaud’s disease won’t have it due to any other disease, and it is more common in women. Cold temperature conditions will cause an attack - sometimes simply walking in the frozen food section in a grocery store is enough. Stressful emotions or vibrating machinery may cause attacks. Severe Raynaud’s disease may occur in autoimmune diseases such as scleroderma or lupus, and can be very disabling. Certain blood pressure or migraine medications can cause or increase Raynaud’s disease symptoms.
A history of one or more fingers or toes turning white with exposure to cold or stress is enough to suggest Raynaud’s disease.Cell phone pictures of white fingers are very helpful to health care providers. In addition to a careful history and physical examination, a magnified examination of the capillaries near the base of the fingernails may suggest an autoimmune disease is present, and specific blood tests may be necessary.
The treatment of Raynaud’s disease depends how long the attacks last, their frequency and whether an autoimmune disease such as scleroderma is present. Avoiding cold exposure is important, and warming the area as soon as the symptoms start may shorten the attacks. Gloves or mittens and hats are recommended. Many Raynaud’s sufferers find disposable hand warmers helpful. Warming and prevention measures may not be enough to prevent or shorten attacks, and prescription medications or creams which dilate the blood vessels have been prescribed with success.